This is Part 1 of the Certified Coding
Specialist (CCS) 16th Edition Exam
Preparation Test Bank by Jennifer Garvin.
TABLE OF CONTENTS - PART 1 of 5
Domain 1: Coding Knowledge and Skills - Diagnosis Coding (ICD-10-CM) - Questions 1-25
Domain 1: Coding Knowledge and Skills - Procedure Coding (ICD-10-PCS) - Questions 26-50
Domain 1: Coding Knowledge and Skills - Outpatient Coding (CPT/HCPCS) - Questions 51-75
Domain 2: Coding Documentation - Questions 76-100
DOMAIN 1: CODING KNOWLEDGE AND SKILLS - DIAGNOSIS CODING (ICD-10-CM)
Q1. A 68-year-old patient is admitted with acute exacerbation of chronic systolic heart failure. The
physician documents "acute on chronic systolic heart failure" as the principal diagnosis. What is the
correct ICD-10-CM code assignment?
A. I50.22
B. I50.23
C. I50.32
D. I50.42
Correct Answer: B
Rationale: Acute on chronic systolic heart failure is coded as I50.23. The term "acute on chronic"
indicates both acute and chronic components, and the systolic designation directs to the .23
subcategory. I50.22 is chronic systolic only, I50.32 is acute on chronic diastolic, and I50.42 is chronic
combined, none of which match the documentation.
,Q2. A patient with hypertensive heart disease and heart failure is admitted. The physician documents
a cause-and-effect relationship between the hypertension and heart failure. What is the correct code
assignment?
A. I11.0 and I50.9
B. I10 and I50.9
C. I11.9 and I50.9
D. I13.0 and I50.9
Correct Answer: A
Rationale: When a cause-and-effect relationship is documented between hypertension and
heart failure, I11.0 (hypertensive heart disease with heart failure) is assigned as the combination
code, with an additional code for the type of heart failure. I10 would be assigned only if the
relationship were not documented. I11.9 does not include heart failure, and I13.0 is for hypertensive
heart and chronic kidney disease.
Q3. A 72-year-old patient is admitted with pneumonia. The physician documents "probable
aspiration pneumonia" in the progress notes. No further documentation clarifies the diagnosis. What
is the correct action?
A. Assign J69.0 for aspiration pneumonia
B. Assign J18.9 for pneumonia, unspecified
C. Query the physician for clarification
D. Assign J15.9 for bacterial pneumonia
Correct Answer: A
Rationale: For inpatient coding, "probable" diagnoses are coded as if confirmed. The physician
documented probable aspiration pneumonia, which directs to J69.0. A query is not required when
the documentation supports the code assignment under inpatient guidelines. J18.9 and J15.9 would
be inaccurate because the physician specified aspiration as the cause.
,Q4. A patient is admitted with a principal diagnosis of sepsis due to methicillin-resistant
Staphylococcus aureus. The physician documents "MRSA sepsis" in the discharge summary. What is
the correct code assignment?
A. A41.9 and B95.62
B. A41.02
C. A41.01 and B95.62
D. A41.9 only
Correct Answer: B
Rationale: Sepsis due to MRSA is coded as A41.02 (sepsis due to methicillin-resistant
Staphylococcus aureus). The combination code includes both the sepsis and the organism, so a
separate code for MRSA is not assigned. A41.9 would be used for unspecified sepsis, and A41.01 is
sepsis due to MSSA, not MRSA.
Q5. A patient with stage 3 chronic kidney disease is admitted for dehydration. The physician
documents "acute renal failure superimposed on chronic kidney disease stage 3." What is the correct
code assignment?
A. N17.9 and N18.3
B. N17.9 only
C. N18.3 only
D. N17.9 and N18.9
Correct Answer: A
Rationale: Acute renal failure (N17.9) and chronic kidney disease stage 3 (N18.3) are both coded
when the documentation indicates acute failure superimposed on chronic disease. Both conditions
affect patient management and are reportable. N17.9 alone omits the chronic condition, and N18.9
is unspecified CKD, not stage 3.
Q6. A patient is admitted with diabetic ketoacidosis. The physician documents "type 1 diabetes
mellitus with ketoacidosis." What is the correct code assignment?
, A. E10.10
B. E11.10
C. E13.10
D. E10.9 and E87.2
Correct Answer: A
Rationale: Type 1 diabetes mellitus with ketoacidosis is coded as E10.10. The combination code
captures both the diabetes and the ketoacidosis. E11.10 is for type 2 diabetes with ketoacidosis,
E13.10 is for other specified diabetes, and coding E10.9 with E87.2 would unbundle the combination
code and is incorrect.
Q7. A patient with COPD is admitted with acute bronchitis. The physician documents "acute
bronchitis due to COPD exacerbation." What is the principal diagnosis?
A. J44.1
B. J20.9
C. J44.0
D. J44.1 and J20.9
Correct Answer: C
Rationale: COPD with acute lower respiratory infection is coded as J44.0. The documentation
specifies acute bronchitis due to COPD exacerbation, which directs to J44.0 as the principal diagnosis.
J44.1 is COPD with acute exacerbation without infection, J20.9 is acute bronchitis unspecified, and
coding both would be incorrect sequencing.
Q8. A patient is admitted for a total knee replacement due to severe osteoarthritis. The physician
documents "end-stage osteoarthritis of the right knee." What is the principal diagnosis?
A. M17.11
B. M17.0
Specialist (CCS) 16th Edition Exam
Preparation Test Bank by Jennifer Garvin.
TABLE OF CONTENTS - PART 1 of 5
Domain 1: Coding Knowledge and Skills - Diagnosis Coding (ICD-10-CM) - Questions 1-25
Domain 1: Coding Knowledge and Skills - Procedure Coding (ICD-10-PCS) - Questions 26-50
Domain 1: Coding Knowledge and Skills - Outpatient Coding (CPT/HCPCS) - Questions 51-75
Domain 2: Coding Documentation - Questions 76-100
DOMAIN 1: CODING KNOWLEDGE AND SKILLS - DIAGNOSIS CODING (ICD-10-CM)
Q1. A 68-year-old patient is admitted with acute exacerbation of chronic systolic heart failure. The
physician documents "acute on chronic systolic heart failure" as the principal diagnosis. What is the
correct ICD-10-CM code assignment?
A. I50.22
B. I50.23
C. I50.32
D. I50.42
Correct Answer: B
Rationale: Acute on chronic systolic heart failure is coded as I50.23. The term "acute on chronic"
indicates both acute and chronic components, and the systolic designation directs to the .23
subcategory. I50.22 is chronic systolic only, I50.32 is acute on chronic diastolic, and I50.42 is chronic
combined, none of which match the documentation.
,Q2. A patient with hypertensive heart disease and heart failure is admitted. The physician documents
a cause-and-effect relationship between the hypertension and heart failure. What is the correct code
assignment?
A. I11.0 and I50.9
B. I10 and I50.9
C. I11.9 and I50.9
D. I13.0 and I50.9
Correct Answer: A
Rationale: When a cause-and-effect relationship is documented between hypertension and
heart failure, I11.0 (hypertensive heart disease with heart failure) is assigned as the combination
code, with an additional code for the type of heart failure. I10 would be assigned only if the
relationship were not documented. I11.9 does not include heart failure, and I13.0 is for hypertensive
heart and chronic kidney disease.
Q3. A 72-year-old patient is admitted with pneumonia. The physician documents "probable
aspiration pneumonia" in the progress notes. No further documentation clarifies the diagnosis. What
is the correct action?
A. Assign J69.0 for aspiration pneumonia
B. Assign J18.9 for pneumonia, unspecified
C. Query the physician for clarification
D. Assign J15.9 for bacterial pneumonia
Correct Answer: A
Rationale: For inpatient coding, "probable" diagnoses are coded as if confirmed. The physician
documented probable aspiration pneumonia, which directs to J69.0. A query is not required when
the documentation supports the code assignment under inpatient guidelines. J18.9 and J15.9 would
be inaccurate because the physician specified aspiration as the cause.
,Q4. A patient is admitted with a principal diagnosis of sepsis due to methicillin-resistant
Staphylococcus aureus. The physician documents "MRSA sepsis" in the discharge summary. What is
the correct code assignment?
A. A41.9 and B95.62
B. A41.02
C. A41.01 and B95.62
D. A41.9 only
Correct Answer: B
Rationale: Sepsis due to MRSA is coded as A41.02 (sepsis due to methicillin-resistant
Staphylococcus aureus). The combination code includes both the sepsis and the organism, so a
separate code for MRSA is not assigned. A41.9 would be used for unspecified sepsis, and A41.01 is
sepsis due to MSSA, not MRSA.
Q5. A patient with stage 3 chronic kidney disease is admitted for dehydration. The physician
documents "acute renal failure superimposed on chronic kidney disease stage 3." What is the correct
code assignment?
A. N17.9 and N18.3
B. N17.9 only
C. N18.3 only
D. N17.9 and N18.9
Correct Answer: A
Rationale: Acute renal failure (N17.9) and chronic kidney disease stage 3 (N18.3) are both coded
when the documentation indicates acute failure superimposed on chronic disease. Both conditions
affect patient management and are reportable. N17.9 alone omits the chronic condition, and N18.9
is unspecified CKD, not stage 3.
Q6. A patient is admitted with diabetic ketoacidosis. The physician documents "type 1 diabetes
mellitus with ketoacidosis." What is the correct code assignment?
, A. E10.10
B. E11.10
C. E13.10
D. E10.9 and E87.2
Correct Answer: A
Rationale: Type 1 diabetes mellitus with ketoacidosis is coded as E10.10. The combination code
captures both the diabetes and the ketoacidosis. E11.10 is for type 2 diabetes with ketoacidosis,
E13.10 is for other specified diabetes, and coding E10.9 with E87.2 would unbundle the combination
code and is incorrect.
Q7. A patient with COPD is admitted with acute bronchitis. The physician documents "acute
bronchitis due to COPD exacerbation." What is the principal diagnosis?
A. J44.1
B. J20.9
C. J44.0
D. J44.1 and J20.9
Correct Answer: C
Rationale: COPD with acute lower respiratory infection is coded as J44.0. The documentation
specifies acute bronchitis due to COPD exacerbation, which directs to J44.0 as the principal diagnosis.
J44.1 is COPD with acute exacerbation without infection, J20.9 is acute bronchitis unspecified, and
coding both would be incorrect sequencing.
Q8. A patient is admitted for a total knee replacement due to severe osteoarthritis. The physician
documents "end-stage osteoarthritis of the right knee." What is the principal diagnosis?
A. M17.11
B. M17.0
